{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "IVYY, P.C",
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"MiddleName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2965 HARRISON ST STE 313",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEAUMONT",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77702-1113",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-838-4472",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2965 HARRISON ST STE 313",
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"PracticeLocationAddressCityName": "BEAUMONT",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77702-1113",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-838-4472",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/26/2006",
"LastUpdateDate": "05/20/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RISTON",
"AuthorizedOfficialFirstName": "VIDA",
"AuthorizedOfficialMiddleName": null,
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"AuthorizedOfficialCredential": "CNM, FNP",
"AuthorizedOfficialTelephoneNumber": "409-838-4472",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "540793",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}